前列地尔脂微球注射液联合银离子敷料治疗糖尿病足的临床观察  

Clinical Observation of Alprostadil Lipid Microsphere Injection Combined with Silver Ion Dressing on Diabetic Foot

作　　者：勾煜成 曾毅文 李文君[1] 王建敏[1] 廖娟[1] 

机构地区：[1]重庆医科大学附属永川医院,重庆402160

出　　处：《中国药房》2014年第8期714-716,共3页China Pharmacy

摘　　要：目的:观察前列地尔脂微球注射液联合银离子敷料治疗糖尿病足的临床疗效和安全性。方法:将104例2型糖尿病患者按随机数字表法均分为治疗组和对照组。治疗组患者给予前列地尔脂微球注射液10μg加入0.9%氯化钠注射液100 ml中静脉滴注,qd;足部溃疡给予0.9%氯化钠清洗后,按溃疡面积给予爱康肤银离子敷料贴于创面。对照组患者给予丹参注射液20 ml加入0.9%氯化钠注射液250 ml中静脉滴注,qd,足部溃疡给予0.9%氯化钠清洗后,用碘伏、双氧水消毒杀菌,创面用无菌纱布覆盖并固定于创面。两周为1个疗程,两组患者均治疗2个疗程。观察所有患者的临床疗效及治疗前后血液流变学、胫后神经传导速度、足部动脉血流速度、踝动脉/肱动脉(ABI)值、溃疡面分泌物细菌培养结果、换药次数及不良反应发生情况。结果:治疗组患者总有效率显著高于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者血浆黏度、血小板聚集率、纤维蛋白原均低于同组治疗前,且治疗组低于对照组;胫后神经传导速度、足部动脉血流速度、ABI值及溃疡面分泌物细菌阴性例数均显著高于同组治疗前,且治疗组高于对照组,差异均有统计学意义(P<0.05)。治疗组患者换药次数显著少于对照组,两组比较差异有统计学意义(P<0.05)。除治疗组患者出现1例左上肢静脉炎外,其他患者均未见明显不良反应发生。结论:前列地尔脂微球注射液联合银离子敷料治疗糖尿病足,疗效显著,且安全性较好。OBJECTIVE： To observe clinical efficacy and safety of Alprostadil lipid microsphere injection combined with silver ion dressing on diabetic foot. METHODS： 104 patients with type 2 diabetes were randomly divided into therapy group and control group. Therapy group received Alprostadil lipid microsphere injection 10 pg diluted in 0.9% Sodium chloride injection 100 ml intravenously, once a day; cleaning the diabetic foot ulcer with 0.9% sodium chloride followed by Aikangfu silver ions dressing on the wound accerding to ulcer area. Control group received Danshen injection 20 ml diluted in 0.9% Sodium chloride injection 250 ml intravenously once a day; cleaning the diabetic foot ulcer with 0.9% sodium chloride, disinfecting with iodophor and hydrogen peroxide followed by sterile gauze covering and fixing the wound. Both groups were treated for 2 courses, 2 weeks as a course. Clinical efficacy, hemorrheology, posterior tibial nerve conduction velocity, foot artery blood flow velocity, ankle/brachial index （ABI）, bacterial culture results of secretion from ulcer surface, the frequency of dressing change and ADR of all patients were observed before and after treatment. RESULTS： The total effective rate of therapy group is significantly higher than that of control group; there was statistical significance （P〈0.05）. After treatment, blood viscosity, platelet aggregation rate and fibrinogen concentration of 2 groups were all lower than before, and those of therapy group were lower than those of control group; while posterior tibial nerve conduction velocity, artery blood flow velocity, ABI and negative culture results of secretion from ulcer surface in two groups after treatment were higher before, and those of therapy group were higher than those of control group; there were statistical significance （P〈0.05）. The times of dressing change in therapy group were significantly less than in control group; there were statistical significance （P〈0.05）. A patient suffered from left upper limb phlebitis i

关 键 词：前列地尔 脂微球载体 银离子敷料 糖尿病足 

分 类 号：R587.1[医药卫生—内分泌]